Effect of the presence of pneumonia on noninvasive ventilation success in chronic obstructive pulmonary disease cases with acute hypercapnic respiratory failure

Abstract

To investigate the effect of the presence of pneumonia on the success of noninvasive mechanical ventilation (NIMV) in chronic obstructive pulmonary disease (COPD) cases with acute respiratory failure. Materials and methods: Sixty patients admitted to the intensive care unit (ICU) due to COPD exacerbation were included. The patients were divided into 2 groups as those with pneumonia (Group 1) and without pneumonia (Group 2). According to initial pH values, cases were also divided into 3 subgroups based on pH values. C-reactive protein (CRP), APACHE II scores, requirement of endotracheal intubation, mortality, and duration of ICU and hospital stay were also recorded. Results: NIMV success was found to be 85.5% in Group 1 and 51.1% in Group 2. Endotracheal intubation rates were higher in Group 2 (P = 0.008). NIMV failure was 70.1% in Group 2 and 10% in Group 1 in patients with severe acidosis. The APACHE II scores and CRP levels were significantly higher and independent risk factors in patients with NIMV failure (P < 0.002, P < 0.001). A significant difference was not found between groups in terms of duration of hospital and ICU stays and mortality. Conclusion: The presence of pneumonia in COPD cases is a factor that reduces NIMV success, but this does not affect mortality and the duration of ICU and hospital stay.